奥沙利铂联合含氟或紫杉类化疗方案致药物不良反应的临床分析

发布时间：2018-04-14 07:35

本文选题：奥沙利铂 + 药物不良反应　；参考：《中国临床药理学杂志》2017年14期

【摘要】：目的分析奥沙利铂药物不良反应(ADR)的临床特点和防范策略,为临床合理用药提供依据。方法 2011年1月至2016年12月在本院用奥沙利铂治疗后发生的ADR病例共78例。收集所有病例的临床资料并对其用药后ADR发生时间、化疗方案及治疗周期、发生ADR时奥沙利铂的累积剂量、临床表现、严重程度及应对策略进行归纳分析。结果患者主要涉及结直肠癌、胃癌、宫颈癌、卵巢癌及其他癌症,全部用含奥沙利铂化疗方案。发生ADR的化疗方案有紫杉醇+奥沙利铂(TP方案)、多西他赛+奥沙利铂(DP方案)、奥沙利铂+卡培他滨(XELOX方案)、奥沙利铂+亚叶酸钙+氟尿嘧啶(m FOLFOX6方案)、mFOLFOX6+贝伐单抗方案、在mFOLFOX6方案的基础上加大奥沙利铂剂量的FOLFOX7方案、氟尿嘧啶+奥沙利铂(FP方案)和替吉奥联合奥沙利铂方案,均为含氟或紫杉类化疗方案。其中,mFOLFOX6方案和TP方案发生ADR的比例较高,分别是43.59%和30.77%。奥沙利铂的ADR常发生于用药后的5~30min(53.85%),一般均会在24 h内发生。临床表现以皮肤及其附件损害(36.05%)、呼吸系统损害(27.21%)最为常见。结论奥沙利铂联合含氟或紫杉类化疗方案易发生ADR;用奥沙利铂24 h内、特别是用药的前30 min应密切关注其ADR,发生3~4级ADR者,建议停用奥沙利铂。
[Abstract]:Objective to analyze the clinical characteristics and preventive strategies of oxaliplatin adverse reactions (ADRs) in order to provide evidence for rational drug use.Methods from January 2011 to December 2016, 78 cases of ADR were treated with oxaliplatin in our hospital.The clinical data of all cases were collected and the time of occurrence of ADR, chemotherapy regimen and treatment cycle, cumulative dose, clinical manifestation, severity and coping strategy of oxaliplatin in ADR were summarized and analyzed.Results patients with colorectal cancer, gastric cancer, cervical cancer, ovarian cancer and other cancers were treated with oxaliplatin chemotherapy regimen.The chemotherapy regimens for the occurrence of ADR include paclitaxel oxaliplatin TP, docetaxel oxaliplatin DP, oxaliplatin capecitabine XELOX, oxaliplatin calcium folate fluorouracil m FOLFOX6 and mFOLFOX6 bevacizumab.On the basis of the mFOLFOX6 regimen, the FOLFOX7 regimen with increased oxaliplatin dose, the fluorouracil oxaliplatin / FP regimen and the tigeo combined with oxaliplatin regimen were either fluorine-containing or yew chemotherapy regimens.The proportion of ADR in mFOLFOX6 and TP was 43.59% and 30.77% respectively.The ADR of oxaliplatin usually occurs at 530 min after administration of oxaliplatin and 53.85 min after administration, usually within 24 h.The most common clinical manifestations were skin and adnexal lesions (36.05%) and respiratory injury (27.21%).Conclusion oxaliplatin combined with fluorine or yew chemotherapy is prone to ADR.The oxaliplatin should be paid close attention to within 24 hours, especially in the first 30 min of treatment. It is suggested that oxaliplatin should be stopped if 3 grade 4 ADR occurs.
【作者单位】：河北医科大学第四医院药学部;
【基金】：河北省人力资源和社会保障厅留学回国人员科技活动择优基金资助项目(20100313) 河北省中医药管理局科研计划基金资助项目(2013161)
【分类号】：R979.1

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